title: Trends in the surgical management of epithelial ovarian cancer in East Anglia 1995-2006.
abstract: BACKGROUND
  Surveillance of trends in cancer management can help in service evaluation and quality improvement.
  
  
  METHODS
  We used East Anglia cancer registration data from 1995-2006 on 3063 patients with epithelial ovarian cancer. We described treatment patterns and examined their predictors using multivariate logistic regression.
  
  
  RESULTS
  Use of chemotherapy (with/without surgery) and of surgery (with/without chemotherapy) remained stable over time (59% and 69% of patients, respectively). Use of surgery was less frequent in most deprived compared with most affluent patients (64% vs. 73% respectively; adjusted per increasing deprivation group quintile OR = 0.88, p = 0.001). Among patients treated by surgery, use of omentectomy and of exenteration increased over time (37% in 1995-8 vs. 56% in 2003-6 for omentectomy, and 2% vs. 8% for exenteration respectively, p < 0.001 for both). More deprived patients were less likely to be treated with omentectomy [42% vs. 53% for most deprived and more affluent patients respectively (adjusted OR = 0.91, p = 0.017)].
  
  
  CONCLUSIONS
  Socioeconomic differences in use of ovarian cancer surgery require further elucidation. Use of some types of surgery increased over time, potentially reflecting changes in service organisation. The findings provide a 'benchmark' for future treatment pattern surveillance, and regional or international comparisons.
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK. gl290@medschl.cam.ac.uk
authors.forename: G
authors.initials: G
authors.lastname: Lyratzopoulos
authors.forename: H
authors.initials: H
authors.lastname: Newsome
authors.forename: J
authors.initials: J
authors.lastname: Barbiere
authors.forename: K
authors.initials: K
authors.lastname: Bolton
authors.forename: K
authors.initials: K
authors.lastname: Wright
authors.forename: H
authors.initials: H
authors.lastname: Kitchener
authors.forename: D
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant; D015986:Confounding Factors, Epidemiologic; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009852:Omentum / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D012042:Registries; D012107:Research Design; D012959:Socioeconomic Factors